Mountain Family Health column: Colorectal cancer and you
To increase awareness about colorectal cancer and the importance of screening for this prevalent disease, Mountain Family Health Centers is participating in Colorectal Cancer Awareness Month in March by sharing information about colorectal cancer, its signs and symptoms and how to prevent this disease.
In the United States, colorectal cancer is the second leading cause of death from cancer. It is the third most commonly diagnosed cancer in both men and women. According to the American Cancer Society, approximately 4.6 percent of men (one in 22) and 4.2 percent of women (1 in 24) women will be diagnosed with colorectal cancer in their lifetime. They estimated in the United States in 2017, 135,430 people would be diagnosed with colorectal cancer with about 50,260 people dying from the disease.
Colorado has a relatively low incidence of colorectal cancer as compared to other parts of the nation, likely due to the overall good health of the population. In Colorado for the period of 2009 to 2013, for every 100,000 persons, 36.2–42.7 males and 13.0-15.2 females were diagnosed with colorectal cancer. For 2010 to 2014, 13.0-15.2 males and 9.7-11.6 females per 100,000 persons died from colorectal cancer (American Cancer Society). Locally, 636 persons were diagnosed with colorectal cancer in 2015 (Colorado Health Information Dataset).
Colorectal cancer affects all racial and ethnic groups and is most often found in people ages 50 and older, with the risk increasing with age. Persons who are African American, smoke or use alcohol heavily, are obese, or have a family history of colorectal cancer are at higher risk.
The best way to prevent colorectal cancer is to get screened regularly starting at age 50. There are often no signs or symptoms of colorectal cancer, so it is important to get screened.
Dr. Chris Tonozzi, a Mountain Family Health Centers family practice physician suggests the most inexpensive way to have a screen is to have a sample of your stool tested at your primary care provider’s annually from when you turn 50 on (Mountain Family charges $25 for this test). More extensive testing may be warranted depending upon the results and your risk factors.
Often the next step is a colonoscopy, an outpatient procedure where you are lightly sedated, and a gastroenterologist looks at your colon and rectum using a colonoscope. The gastroenterologist can remove polyps, which are small growths of cells that may become cancerous over time, and biopsy any suspicious sites during the procedure. Recommended frequency for colonoscopies is usually five to 10 years depending on the doctor’s findings and your risk status.
Another newer screening technology is the virtual colonoscopy or computed tomographic colonography (CTC).
Persons at higher risk of getting colorectal cancer are often recommended to have colonoscopies beginning at an earlier age or frequently.
What are the signs and symptoms of colorectal cancer to watch for?
• Bleeding from the rectum
• Blood in the stool or in the toilet after having a bowel movement
• Dark or black stools
• A change in bowel habits or the shape of the stool (e.g., more narrow than usual)
• Cramping or discomfort in the lower abdomen
• An urge to have a bowel movement when the bowel is empty
As with any health concern, if you are experiencing any of these symptoms or are worried about your health, schedule an appointment with your primary care provider to discuss them.
Colorectal cancer is usually treatable, depending on how extensive the cancer is and whether it has spread to other parts of the body. The first line of treatment is usually surgery to remove the tumor. Chemotherapy may follow, if warranted. Radiation is used less often as treatment for colorectal cancer than other types of cancer.
In addition to screening starting at age 50, how can you prevent colorectal cancer? Encourage your family and friends to also get screened starting at age 50; eat a healthy diet and get plenty of physical activity; maintain a healthy weight; use alcohol lightly or not at all; and quit smoking and avoid secondhand smoke.
For more information, on colorectal cancer and your risk, Mountain Family Health Centers encourages you to talk to your primary care provider. If you do not have one, Mountain Family accepts all persons with any type of insurance and those who do not have insurance, regardless of ability to pay. To learn more about Mountain Family, please visit www.mountainfamily.org.
Carolyn Hardin is a development consultant for Mountain Family Health Centers and other nonprofits, with 30 years of experience in public health and human services in the Roaring Fork Valley. She can be reached at Chardin@mountainfamily.org